| NPI | 1558768226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN R224041-5) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 175113-30) |
| Enumeration Date | 2014-11-25 |
| Last Update Date | 2015-12-02 |